244. Nepal Day 11

Back to work today. Concluding that during the previous week too many cases went too far into the evening, the decision was made to cut back surgeries: 4 operating room tables instead of 5.  

An anesthesiologist from Kathmandu helped today and hearing our stories of unexpected blood loss said that in his practice the expectation is that almost all hysterectomies will have sufficient blood loss to require transfusion.  We think maybe some dietary deficiency--some missing mineral vital to the blood clotting mechanism.  Dietary yes, but not deficiency.  Garlic, for example, is an anticoagulant, perhaps ginger as well, both common ingredients in local cooking.

Several providers ill with gastroenteritis.  I estimate that with each mission, 10-15% of participants at some point become incapacitated, though usually for just 1-2 days. Rest, fluids (sometimes intravenous), and antibiotics for travelers' gastroenteritis usually are sufficient.  I'm lucky, I remember just one afternoon in Malawi, when I returned to my room, just feeling poorly, perhaps lingering jet lag/sleep deprivaton, since I felt better after several hours sleep).  True GI illness did get me a couple of times, but on the way home so didn't disruption mission activities.